Issue link: https://www.massageandbodyworkdigital.com/i/1102144
Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 59 Intake 1 (2 minutes) You noticed on this person's intake form that they indicated they were treated for breast cancer five years ago. The person did not contact you for "oncology massage." This person is a new client. Therapist: I see from your intake that you were treated for breast cancer in 2014. Did you have lymph nodes removed? Lymphedema can be a big concern. Client: I think I had lymph nodes removed. I can't remember whether I did or even how many. Therapist: OK. If you had nodes removed, then you maybe had radiation, which means that you're at risk for lymphedema anyway, so we can keep that in mind. Client: OK, but it was five years ago. Do you really think it matters? Therapist: It's hard to believe, but lymphedema is actually a lifelong risk. What about neuropathy? It looks like you had a couple of chemo drugs that can cause neuropathy. Client: Sort of? I mean, my toes are a little tingly sometimes, but it's not that bad. I don't really think about it. Therapist: OK, so nothing serious. We won't worry about that today, but I do know a protocol to address that if you decide you want to do that next time. Client: OK. A Tale of Two Intakes These are two very human exchanges. Neither of them is "wrong," but can you see the different intent in each? One is designed, probably unconsciously, to show the client how much the therapist knows. One is designed to learn about the client and to let the client guide the session and focus. I invite you to imagine that you are the client in each of these. How would the first intake likely make you feel? What about the second? Therapist: I noticed that you said you're taking Herceptin. Lots of my clients complain about hot flashes, hair thinning, joint pain. When my mom was taking it, she had every symptom you can imagine. I was always putting the hot rice bag in the microwave for her. Client: Well, I do, but it doesn't really affect me that much. And I'm 59, so it's hard to know if it's the medication or just actual menopause. Therapist: I guess that's true. Herceptin is notorious for causing symptoms that mimic menopause, so who knows? Client: I didn't know that about Herceptin. Therapist: It says here that you row. I saw a woman last week who races those dragon boats. That's really popular with breast cancer survivors around here. Client: Yeah. I just started. A friend kind of made me go. She's always trying to get me to do social things and meet new people and "live" (rolls her eyes gently). I'm not sure about it yet. Therapist: All my clients who do it love it. I'm sure you will too. Client: So, last week after a rowing meetup, my shoulder started hurting right here [client points to anterior deltoid/pec attachment]. I always worry when I get new pains, but I'm guessing it's just from the rowing. Therapist: In that location, it's really unlikely that it's a cancer recurrence and the range of motion issues that often go with breast cancer treatment can cause pain for survivors when they wouldn't cause pain for healthy people. Client: [somewhat stunned by the suggestion, even if indirect, that her shoulder pain could be pain from an undetected recurrence] Well, it hurts when I move it, and it's been hard to sleep on it. Therapist: Sounds good. Let's get you on the table. I'm going to have you lie face up just to stay mindful about lymphedema, and I'm not going to work too deeply because of your history. Any questions? Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 59